How to tackle 'middle of the night' anxiety

Anxiety can come alive at night – and it can be a vicious cycle.

Not only can anxious thoughts lead to insomnia and other sleep problems, but a lack of sleep can also contribute to both anxiety and stress.

‘Anxiety triggers our fight or flight response which is the body’s way to prepare us for action against the threat – not the ideal state to try to get to sleep,’ says consultant health psychologist Dr Sue Peacock.

‘Unfortunately, this cycle only continues to get worse if you don’t sleep enough at night, as your body boosts its level of stress hormones. 

‘This is because the brain chemicals that relate to deep sleep are the same ones that tell your body to stop the production of stress hormones.

‘So as a result, if you don’t sleep well, your body keeps pumping out these hormones, so the next day you feel even more stressed. And the following night you find it hard to sleep – then you get stuck in this circle.’

There’s nothing worse than lying in bed staring at the ceiling with anxious thoughts whirling around – thinking about how much you want to sleep, but also unable to shift these worries.

What’s more, we know that sleep is vital for regulating our mood, making us feel better and for our general health – so it’s vital to tackle any issues that may be disrupting it.

If ‘middle of the night’ anxiety is keeping you up, experts have shared some things to try.

Put the day to rest via journaling 

Dr Sue Peacock says to use the method of journaling to release any anxieties from the day.

She comments: ‘A few hours before bed, think about your day and write down, what has gone well, what hasn’t gone – can you do anything about it? And what do you need to remember tomorrow.

‘These factors are usually the ones that keep us awake, but by doing this we have had chance to process the day before going to bed.’

Attempt ‘thought switching’ and ‘thought stopping’

There are two different techniques, in particular, that can help distract a mind from anxious thoughts during the night.

The first one of these is ‘thought switching.’

‘Think of a place where you feel calm and relaxed – it could be a beach, a country walks, your garden etc – and describe it in great detail to yourself, mouthing the words as you speak rather than keeping them in your mind,’ says Dr Sue Peacock

There’s also ‘thought stopping’ – which is where a person thinks of the word ‘the’ every two seconds. 

‘Rarely will you get beyond five minutes before you are sleeping,’ continues Dr Sue.

‘This works as it blocks your negative thoughts and because the word “the” doesn’t mean anything or have any emotion attached to it, your mind won’t wander.’

Be consistent with your sleep routine

Clinical psychologist Dr Carla Runchman stresses the importance of a consistent bedtime routine as well as good ‘sleep hygiene’ – which essentially means having an environment and daily practices that promote uninterrupted sleep.

It’s a good idea to dedicate at least 30 minutes to winding down into your evening routine. 

Dr Carla says: ‘This can be different for different people, for example reading, having a bath or listening to calm music.

‘Physically relaxing your body and helping your mind to recognise when your muscles are relaxed is another evidence-based technique to reduce anxiety.’

Deep breathing

Deep breathing is a simple and effective way to calm the body and help with anxiety and stress.

Dr Don Grant, of The Independent Pharmacy, says: ‘Breathing deeply boosts the supply of oxygen to the brain. This stimulates the parasympathetic nervous system, which controls bodily functions during times of stress.

‘The result is that people can feel calmer and less anxious, helping them get back to sleep.’ 

Try the 5-4-3-2-1 method

If you have anxiety, you may be familiar with the 5-4-3-2-1 tool – which aims to help people ground themselves when having an episode or panic attack.

‘It uses recognition of the five senses to ease anxiety’ says Dr Don Grant.

‘Firstly, people look around their surroundings and spot five things they can see. Secondly, they note four things they can hear. Thirdly, they identify three things they can feel. Fourthly, they pinpoint two things they can smell. Finally, they focus on one thing they can taste.’

Give nighttime meditation a go

Meditation is another great option – although it’s a good idea to get out of bed and into a more calming space before trying this.

‘Find somewhere comfortable and set a quiet alarm or timer on their phone for 20 mins (it’s easier to relax when you know the timer will let you know when the session is over),’ holistic life coach and wellness specialist Nicola Henderson tells Metro.co.uk.

‘Then use mantra meditation which is repeating a statement over and over, it can be done silently in your head or out loud depending on the circumstance, something like “When I sleep my body is rejuvenated and I welcome this time to rest.” 

‘You are reinforcing to your subconscious mind the benefits of a good night’s sleep, while also distracting yourself through the mantra. The repetition of the words is also soothing as it’s rhythmic.’

Set yourself ‘worry time’ during the day 

Dr Elena Touroni, a consultant psychologist and co-founder of The Chelsea Psychology Clinic, says to set yourself a dedicated time and place each day that you can devote to worrying. 

‘It might sound counterintuitive but it can help give you a sense of control over your worries. If a worry shows up in non-worry time (e.g. nighttime), commit to disengaging from the thoughts until your set time,’ she tells Metro.co.uk.

‘Make sure the place you go for worry time is somewhere neutral as it’s likely to become associated with your worrying – not in your bed or favourite chair, for example.’

Ask for help if need be

If these strategies aren’t improving the anxiety, it’s crucial not to struggle alone.

A GP may be able to refer you for cognitive behavioral therapy or other helpful therapies – so be sure to make an appointment if ‘middle of the night’ anxiety continues.

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